Right Ventricle Function: The Role of the Forgotten Chamber in Mitral Valve Surgery

Background: Referred to as the “forgotten chamber,” the right ventricle (RV) is now widely acknowledged as a significant factor, particularly in certain cardiovascular pathologies. Despite historically being undervalued in comparison to the left ventricle, the RV function is deemed crucial in determining patient outcomes following mitral valve (MV) surgery. In the context of MV surgery, it is important to note that the RV is highly susceptible to dysfunction before, during, and after the surgical procedure. This vulnerability is also partly compounded by a lack of precise preoperative assessment, appropriate intraoperative management, and sufficient postoperative care for the RV. Moreover, it is notable that the current preoperative risk-score evaluation does not encompass considerations for the RV. Observations: Sophisticated assessment methodologies, including echocardiography, cardiac magnetic resonance imaging, and invasive hemodynamic procedures, play a pivotal role in accurately evaluating the RV function in patients undergoing MV surgery. These methodologies offer invaluable insights into the extent of RV dysfunction both pre- and postoperatively. By furnishing precise measurements of RV performance, these techniques contribute to risk stratification, guide perioperative management, and may enhance surgical outcomes. Their integration into routine clinical practice is essential for optimizing patient care in the context of MV surgery. Conclusions: This review highlights the importance of evaluating the RV before surgery, ensuring proper perioperative care, and utilizing advanced imaging to monitor RV function in order to predict the outcomes. The goal is to enhance surgical outcomes by thoroughly assessing and supporting RV function during the surgical process.